Rhode Island’s largest Medicaid insurer is suing the state, alleging $100 million in unpaid insurance reimbursements, some of which are more than a decade overdue.
The 20-page complaint was filed by Neighborhood Health Plan of Rhode Island in Providence County Superior Court on Oct. 30, and first reported by The Providence Journal. The Rhode Island Executive Office of Health and Human Services and its interim director, Kristen Sousa, are named as defendants.
Neighborhood contends that the state failed to recalculate and reimburse the nonprofit health insurer for higher costs associated with covering more medically needy residents — primarily those in long-term care and nursing home facilities — breaching its obligations under two pairs of contracts which together spanned 2013 to 2025…